Department of Joint Surgery, Huangshan City People's Hospital, Huangshan, Anhui, China.
Department of Rheumatology, The First Affiliated Hospital of Soochow University, Suzhou, 215000, Jiangsu, China.
J Orthop Surg Res. 2022 Feb 24;17(1):123. doi: 10.1186/s13018-022-03013-8.
Though unicompartmental knee arthroplasty (UKA) is a useful procedure to treat knee osteoarthritis, it remains a great controversial point as to if navigated systems are able to achieve better accuracy of limb alignment and greater clinic results. Current meta-analysis was conducted to explore if better clinical outcomes and radiographic outcomes could be acquired in the navigated system when compared with conventional procedures.
We identified studies in the online databases, including Medline, Embase, the Cochrane Library and Web of Science before May 2021. The PRISMA guidelines in this report were strictly followed. Our research was completed via Review Manager 5.4 software.
Fourteen articles were included, involving 852 knees. The present meta-analysis displayed that the navigated system had remarkably improved outcomes in inliers of mechanical axis (MA) (P < 0.01), MA in the Kennedy's central zone (Zone C) (P = 0.04), inliers of the coronal femoral component (P < 0.01), inliers of the coronal tibial component (P = 0.005), inliers of the sagittal femoral component (P = 0.03), inliers of the sagittal tibial component (P = 0.002) and Range Of Motion (ROM) (P = 0.04). No significant differences were observed in Oxford Knee Score (OKS) (P = 0.15), American Knee Society Knee Score (KSS score) (P = 0.61) and postoperative complications (P = 0.73) between these 2 groups. Regarding operating time, the navigated group was 10.63 min longer in contrast to the traditional group.
Based on our research, the navigated system provided better radiographic outcomes and no significant difference in the risk of complications with longer surgical time than the conventional techniques. But no significant differences were found in functional outcomes. Because the included studies were small samples and short-term follow-up, high-quality RCTs with large patients and sufficient follow-up are required to identify the long-term effect of the navigated system.
尽管单髁膝关节置换术（UKA）是治疗膝关节骨关节炎的有效方法，但对于导航系统是否能够实现更好的下肢对线准确性和更大的临床效果仍存在很大争议。目前的荟萃分析旨在探讨与传统手术相比，导航系统是否能获得更好的临床和影像学结果。
我们在 2021 年 5 月之前在在线数据库中检索了包括 Medline、Embase、Cochrane 图书馆和 Web of Science 在内的研究。本报告严格遵循 PRISMA 指南。我们的研究通过 Review Manager 5.4 软件完成。
共纳入 14 篇文章，涉及 852 膝。本荟萃分析显示，导航系统在机械轴（MA）内的改善明显（P < 0.01），Kennedy 中央区（Zone C）的 MA （P = 0.04），股骨冠状面组件的内区（P < 0.01），胫骨冠状面组件的内区（P = 0.005），股骨矢状面组件的内区（P = 0.03），胫骨矢状面组件的内区（P = 0.002）和活动范围（ROM）（P = 0.04）。两组间 Oxford 膝关节评分（OKS）（P = 0.15）、美国膝关节协会膝关节评分（KSS 评分）（P = 0.61）和术后并发症（P = 0.73）无显著差异。导航组的手术时间比传统组长 10.63 分钟。
根据我们的研究，与传统技术相比，导航系统提供了更好的影像学结果，并发症风险无显著增加，但功能结果无显著差异。由于纳入的研究样本量较小，随访时间较短，需要高质量的 RCT 研究来确定导航系统的长期效果，该研究纳入了大量患者并进行了充分随访。
